Popliteal Artery Injury and Loss of Limb After Intraosseous Needle Placement During Resuscitation

Intraosseous (IO) access is used most frequently for emergent vascular access during the care of critically ill infants and children when intravenous access cannot be rapidly achieved. Although generally safe and effective, complications may occur with extravasation of injected materials or needle damage to soft tissue, bone or vascular structures. We report the rare occurrence of damage to the popliteal artery following IO placement in the proximal tibia of an infant that resulted in distal limb ischemia and loss of limb. Although generally safe and effective, complications may occur with IO placement and its subsequent use related to extravasation of injected materials or needle damage to soft tissue, bone or vascular structures. The history of IO resuscitation is reviewed, techniques of placement discussed, and potential complications outlined.